Epidemiology of Molluscum Contagiosum

Etiology of Molluscum Contagiosum

Pathogen:

Molluscum contagiosum is caused by a DNA virus of the pox group. Incubation period 2–7 weeks. Transmission from human to human via skin-to-skin contact or via inanimate vectors (e.g. towels).

Signs and Symptoms

Isolated or grouped dome-shaped skin-colored papules (1–5 mm).

Manifestation at the face, trunk, axillae and genital region.

Papules can be expressed by lateral pressure (molluscum bodies).

Generalized manifestation can be possible due to immunodeficiency.

Diagnosis

When in doubt, a skin biopsy should be done (virus-infected cells with DNA-containing inclusion bodies).

Treatment of Molluscum Contagiosum

Drug Therapy

Cantharidin:

Cantharidin causes a blistering and inflammation of the skin; this heals the manifestion without scarring. Cure rate 90%. Side effects: blistering, local irritation.

Imiquimod:

5% cream 3× per week for 16 weeks. The immunomodulatory effect causes the release of interferon and tumor necrosis factor. Cure rate 35–85%, as shown in several randomized trials. The benefit of imiquimod is a lower rate of side effects. Disadvantages are the higher treatment costs and relapse rate.

Surgical Therapy

The papules are expressed by lateral pressure or removed with a sharp spoon followed by iodine desinfection. Alternative techniques: cryosurgery.

Prognosis of Molluscum Contagiosum

Molluscum contagiosum is usually a self-limiting disease, which lasts five months to five years (usually within nine months). Longer courses of disease are possible with immunodeficiency.